| Brain injuries and neurological system failure are the most common proximate causes of death in children admitted to a pediatric intensive care unit. | |
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MedLine Citation:
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PMID: 21037501 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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OBJECTIVE: : Mortality rates from critical illness in children have declined over the past several decades, now averaging between 2% and 5% in most pediatric intensive care units. Although these rates, and mortality rates from specific disorders, are widely understood, the impact of acute neurologic injuries in such children who die and the role of these injuries in the cause of death are not well understood. We hypothesized that neurologic injuries are an important cause of death in children. DESIGN: : Retrospective review. SETTING: : Pediatric intensive care unit at Children's Hospital of Pittsburgh, an academic tertiary care center. PATIENTS: : Seventy-eight children who died within the pediatric intensive care unit from April 2006 to February 2008. INTERVENTIONS: : None. MEASUREMENTS AND MAIN RESULTS: : Data regarding admission diagnosis, presence of chronic illness, diagnosis of brain injury, and cause of death were collected. Mortality was attributed to brain injury in 65.4% (51 of 78) of deaths. Ninety-six percent (28 of 29) of previously healthy children died with brain injuries compared with 46.9% (23 of 49) of chronically ill children (p < .05). The diagnosed brain injury was the proximate cause of death in 89.3% of previously healthy children and 91.3% with chronic illnesses. Pediatric intensive care unit and hospital length of stay was longer in those with chronic illnesses (38.8 ± 7.0 days vs. 8.9 ± 3.7 days and 49.2 ± 8.3 days vs. 9.0 ± 3.8 days, p < .05 and p < .001, respectively). CONCLUSION: : Brain injury was exceedingly common in children who died in our pediatric intensive care unit and was the proximate cause of death in a large majority of cases. Neuroprotective measures for a wide variety of admission diagnoses and initiatives directed to prevention or treatment of brain injury are likely to attain further improvements in mortality in previously healthy children in the modern pediatric intensive care unit. |
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Authors:
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Alicia K Au; Joseph A Carcillo; Robert S B Clark; Michael J Bell |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies Volume: 12 ISSN: 1529-7535 ISO Abbreviation: Pediatr Crit Care Med Publication Date: 2011 Sep |
Date Detail:
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Created Date: 2011-09-08 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100954653 Medline TA: Pediatr Crit Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 566-71 Citation Subset: IM |
Affiliation:
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From the Departments of Critical Care Medicine (AKA, JAC, RSBC, MJB), Pediatrics (JAC, RSBC, MJB), and Neurological Surgery (MJB), and the Safar Center for Resuscitation Research (AKA, RSBC, MJB), University of Pittsburgh School of Medicine, Pittsburgh, PA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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